Physicians, patients grappling with financial woes

Physicians are surely feeling the pain of patients' inability to pay their medical bills. Take Dr. Dan Buerger, a surgeon at Pittsburgh Oculoplastic Associates Ltd. Thanks to a struggling economy and increasing levels of patient financial responsibility, his practice's accounts receivable has shot up 50 percent, he tells the Pittsburgh Business Times.

"It's really because of the deductibles and copays," Buerger said. "But the patients often do not understand that they've been moved into a high-deductible plan."

Nationwide, between 15 million and 19 million people are covered by high-deductible health plans, representing between 9 and 11 percent of the privately insured market, according to the Employee Benefit Research Institute, a private nonprofit group based in Washington. And that's just patients with coverage. In 2009, the uninsured population reached 50.7 million--a 9.4 percent increase from 2008 and the largest number since the Census began its current method of estimating the uninsured in 1987, American Medical News reports.

And while individual business owners clearly struggle with an increase in bad debt, employed physicians are not immune from danger, according to Edward Kabala, a partner at Fox Rothschild LLP. The Pittsburgh healthcare attorney told the Times that at least half of the physician contract deals with local academic medical centers include a provision for bill collection, which means a high rate of delinquencies can wipe out a contractual bonus.

For some physicians, such as Jincy Joseph, MD, a family physician in Carpentersville, Ill., it's become necessary to make services more affordable to patients. In reaction to the growing number of uninsured patients and retail clinics and competing medical groups in the area, Joseph and two other Provena Medical Group partner offices in the area recently began offering $65, flat-fee office visits, amednews reports. "We do specials for the school and sports physicals where we give discounted rates for folks who have no insurance or [inadequate insurance]." The special rate for physicals was $40.

For others, despite the controversy, suggesting that patients finance their medical care with a health credit card--many of which come with penalties of up to nearly 30 percent for delinquent payments--is a viable alternative to offering discounts or letting aggressive collection efforts sour their relationships with patients.

That's one of the options being pursued by Buerger, who said he is often torn by the dual roles of physician and small business operator. "We want to be sympathetic, but we're having more and more patients run into this problem," Buerger said. "As a physician, I just want to take care of my patients."

To learn more:
- read the article in the Pittsburgh Business Times
- see the story in American Medical News